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My alarm sounds at 6:30 am, and I turn it off by instinct, my eyes still closed. Before I even have a chance to open them, I feel the steady pounding in my left temple: Migraine. A bad one. But I have chronic migraine, and if I took a sick day every time I had one, I wouldn't have a job—and no job means no health insurance.So I crawl out of bed, take my medication, and hope the pain doesn't get worse.

I was first diagnosed with chronic intractable migraine in 2011, but I have lived with frequent, severe migraines for much longer. Chronic migraine is defined by the as havinga migraine on 15 or more days per month for at least three months,and "intractable" means it's seemingly untreatable.

In college, when my frequent headaches became unbearable, I sought medical help."It’s just stress," the campus doctor told me. "You need to relax." But I knew that having a debilitating headache every day wasn't "just stress."The pain soon became so incessant that I stopped hanging out with my friends, opting instead to sit in my apartment and binge-watch Bones to distract myself from the throbbing in my temples.I survived on takeout, ramen noodles, and frozen pierogies because I didn't have energy to cook. I missed classes and handed assignments in late—in fact, I'm still not sure how I made it through my senior year.

After I graduated, the only healthcare I had access to do was a low-cost clinic in my neighborhood. The doctors there tried to help, but admitted they didn't know much about migraine and urged me to see a specialist. Eventually, the organization I had been working for hired me full-time, and I got health insurance. I almost cried with relief at my first specialist appointment when the doctor gave me the diagnosis—finally, someone was taking my pain seriously. What's more, I now had a plan for managing the condition that had slowly been taking over every bit and piece of my life.

Since then, I’ve tried about a dozen different medications. Some of them did nothing, some made things worse, and a few actually helped.My pain has ranged from terrible to okay to oh-God-I'm-dying to periods of virtually no pain. Now, I swallow a cocktail of medications and supplements every morning and evening, and I'm down to one or two severe migraines per week instead of four.One migraine a week might sound bad, but for me it's the difference between barely surviving and having a life.

It’s taken a long time and a lot of trial and error, but I now know what I need to do to cope with the monster that lives in my head. Mostly it involves being kind to myself and recognizing that there’s no cure for migraine. I've had to accept that even with effective medication, I’ll never be completely migraine-free—that's not awesome, but at least I can plan for it. I stick to a strict sleep schedule. I avoid coffee and alcohol. I build buffers into my schedule so that a sudden migraine doesn't completely derail my plans or cause me to miss a deadline. And if I need to take it easy, I do only what's absolutely necessary, like go to work, and skip anything less essential, like vacuuming. The dog fur will still be there when I’m ready to tackle it, migraine-free.